Update Your Information | SanlamAllianz Nigeria

Customer Contact
Update Form

Kindly input your email address in the form
below to update our record.

<p><section class="sds-life-calculator reclamation contact-update-record">
    <div class="sds-life-calculator__wrapper">
        <form action="/api/updateContactRecord" id="contact-update-record-form" method="POST" role="form">
            <input type="hidden" name="lang" class="form-control" value="en">
            <input type="hidden" name="http_referer" class="form-control" value="self-service/update-your-information">
            <div class="sds-life-calculator-screen-1">
                <small>Fields marked with an <font color="red">*</font> are required</small>
                <div class="sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="mobile">
                                    Mobile Number <font color="red">*</font>
                                </label>
                                <input required type="text" name="MOBILE" class="sd-textfield" minlength="13">
                                <br><small class="error assistive-error">e.g. +2348034037755</small>
                            </div>
                        </div>
                    </div>
                </div>
                <div class=" sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="first_name">
                                    First Name <font color="red">*</font>
                                </label>
                                <input required type="text" name="FIRST_NAME" class="sd-textfield">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="last_name">
                                    Last Name <font color="red">*</font>
                                </label>
                                <input required type="text" name="LAST_NAME" class="sd-textfield">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="email">
                                    Email Address <font color="red">*</font>
                                </label>
                                <input required type="email" name="EMAIL" class="sd-textfield">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="residential-address">
                                    Residential Address
                                </label>
                                <input type="text" name="residential-address" class="sd-textfield">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="social-media-handle">
                                    Social Media Handle
                                </label>
                                <input type="text" name="social-media-handle" class="sd-textfield">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="sds-life-calculator-screen-1__field-container">
                    <div class="sds-life-calculator-screen-1__field-column-one">
                        <div class="sds-life-calculator-screen-1__field-row">
                            <div class="sd-textfield__container sd-textfield__container--full-width">
                                <label class="sd-textfield__label" for="night-time-phone-number">
                                    Night-time phone number
                                </label>
                                <input type="text" name="night-time-phone-number" class="sd-textfield">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="sds-life-calculator-screen-1__button-row">
                    <button type="submit" class="sd-button sds-life-calculator-screen-1__quote-button">
                        <span class="sd-button__container">Submit</span>
                    </button>
                </div>
            </div>
    </div>
    </div>
    </form>
    </div>
</section></p>

Fields marked with an * are required

Mobile Number *
e.g. +2348034037755

First Name *

Last Name *

Email Address *

Residential Address

Social Media Handle

Night-time phone number

Customer Contact Update Form

Connect with an expert near you

Customer Contact
Update Form